Clinical evaluation of endocrine disorders

greenisland

The pace of progress in endocrinology has always been dictated by the development of assays to measure the hormones. By and large, clinical endocrinology is limited to the measurement of hormone concentrations in venous serum or body fluids such as urine or saliva. Interpretation of the results of these assays should always take into account three factors - the clinical features of the patient, the concentration of the variable regulated by the hormone, and the concentration of other hormones in the feedback loop. For example, a serum insulin concentration can only be interpreted in light of the simultaneous glucose concentration and correct interpretation of thyroid, adrenal or gonadal hormone concentrations requires in many cases the results of the appropriate pituitary hormone concentrations. Tests of the feedback loops may be used; in general, in situations in which hormone concentrations are expected to be high, suppression tests are used and in those in which low concentrations are expected stimulation tests are used